Prevalence and prediction of prolonged pruritus after severe burns

• Published in: Journal of burn care & research 2015-05, Vol.36 (3), p.405-413
• Main Authors: Gauffin, Emelie, Öster, Caisa, Gerdin, Bengt, Ekselius, Lisa
• Format: Article
• Language: English
• Subjects: Adult; Burns - epidemiology; Burns - psychology; Comorbidity; Disease Progression; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prevalence; Pruritus - epidemiology; Pruritus - psychology; Severity of Illness Index; Surveys and Questionnaires; Survivors - psychology; Survivors - statistics & numerical data; Sweden - epidemiology; Young Adult
• ISSN: 1559-047X; 1559-0488; 1559-0488
• DOI: 10.1097/BCR.0000000000000152

Years after injury, pruritus is a common and severe problem for many burn patients. However, its characteristics and consequences are often only partially described. The authors therefore performed a prospective detailed examination of burn- and individual-related factors and considered those in relation to pruritus severity. Sixty-seven consecutive burn patients were assessed during acute care, and at 3 and 12 months postburn regarding preburn psychiatric disorders, health-related quality of life, post traumatic stress disorder, and personality traits. Postburn pruritus was subsequently assessed 2 to 7 years postburn using the Questionnaire for Pruritus Assessment. Fifty-one individuals, 76% of the participants, reported burn pruritus any time after the burn. Thirty-three individuals, 49% of the participants, reported ongoing pruritus the last 2 months. Information on the characteristics of pruritus was obtained from 32 of these individuals. Most perceived pruritus as bothersome or annoying and as present every day, 16 (50%) were considered to have severe pruritus, and 11 (34 %) scratched themselves to the point of bleeding. In logistic regressions, this was independently related to TBSA full-thickness burn and health-related quality of life at 3 months, and to TBSA full thickness burn and the personality trait impulsiveness, respectively. About half of the previous burn patients experienced ongoing pruritus on an average of 4.5 years after injury, and half of them had severe pruritus. Scratching oneself to the point of bleeding is linked both to a certain personality and to pruritus. It is suspected that many patients are left without access to the best available treatment.